- As medications like Ozempic and Wegovy have grown in popularity due to their effectiveness in aiding with weight loss, so too has the stigma around using them.
- People are reporting being shamed for using these medications by some who mistakenly believe that chronic obesity can be treated solely with lifestyle changes in diet and exercise.
- Health experts warn the growing stigma surrounding the use of these medications could discourage some people from seeking treatment.
Christian Miller, the founder of Discover Italy, says trying to achieve a healthy weight was a difficult challenge throughout his early 20s.
During that time, people — none of whom were healthcare professionals — told him to eat less. Others compared him to animals, and even waiters would sometimes make snarky comments when he ordered food.
“It was difficult living in an obese body because I felt like people were judging me for something out of my control,” says Miller. “They would call me by names or tell me to lose weight, which made me feel like I was never going to get better. It took a long time for me to come to terms with my condition and start taking action to take control of my health and life.”
That time came when Miller was diagnosed with type 2 diabetes. A doctor prescribed Ozempic (semaglutide) to help him manage his blood sugar and weight.
He’s now 170 pounds and says he’s proud of his progress. Though even as he began to lose weight, people still made negative remarks. Only now, the comments weren’t about his weight but how he was going about losing it.
Miller says he got unhelpful comments such as, “You should just eat less” or “exercise more,” implying that his use of medication to help treat his obesity was somehow “cheating” and that he was failing to lose weight the “right” way.
Miller’s experience isn’t unique. Ozempic use has become a punchline on social media platforms and in pop culture, including at the Oscars, where host Jimmy Kimmel quipped about the drug and Hollywood’s use of it.
“Individuals with obesity can often internalize weight stigma and the idea that they should be able to just diet and exercise to lose weight,” Genna Hymowitz, Ph.D., a licensed psychologist at Stony Brook Medicine and Director of Bariatric and Weight Loss Psychology. “Many patients I see have received this message their whole lives from family, friends, peers, medical providers, and the media.”
Experts are raising concerns that the growing stigma and shame surrounding the use of drugs like Ozempic and Wegovy may keep those who need them most from seeking treatment.
Health experts say the growing class of drugs known as GLP-1 agonists — which includes Ozempic — are powerful new tools that can help treat obesity.
“The available research on these medications suggests that they can make a significant difference for those patients that have difficulty losing weight and managing comorbid health conditions with lifestyle changes alone,” says Hymowitz.
The research and approvals also indicate that neither is considered a cure-all for obesity, a common myth.
While it’s become a catch-all term for several weight loss drugs, technically Ozempic is only FDA-approved for diabetes management in conjunction with diet and exercise, though some people have been taking it off-label for weight loss.
Miller qualified for Ozempic as someone living with diabetes.
However, Wegovy (another brand name for a different type of semaglutide) was FDA-approved
In fact, a 2021 trial suggested that once-weekly, 2.4 mg injections of Wegovy could help reduce body weight when paired with lifestyle modifications.
Despite the growing stigma, experts say these medications — along with diet and exercise — are critical treatments for many patients living with chronic obesity.
“Diet and exercise can be enough in many cases…but just making that recommendation without a comprehensive strategy results in massive long-term failure when dealing with a chronic and complex condition,” says Jamie Kane, MD, the director of the Northwell Health Center for Weight Management and chief of the Section of Obesity Medicine. “What the medications do is work on factors that make it more likely that patients will get an acceptable amount of weight loss by helping control appetite, satiety, and insulin sensitivity.”
Experts say there are several reasons, and the high-profile punchlines like those made at the Oscars certainly don’t help. Ditto for comments about providers prescribing Ozempic to lose a couple of quick pounds, like those made by Chelsea Handler earlier this year on the Call Her Daddypodcast.
At the heart of the matter, is the myth that obesity is something people could control if only they tried harder, ate better, and exercised more.
“If someone had a larger body, they were thought of as simply lacking willpower and motivation to make changes,” says Hymowitz. “For years, this myth was perpetuated by the healthcare community and society in general, and many people still believe this myth.”
It perpetuates the idea that taking a prescription drug like Ozempic or Wegovy is a cop-out, so a person doesn’t have to put in the work associated with making dietary and physical activity changes.
“Using a medication is seen as a sign of weakness,” says Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center.
Experts also point out that we don’t shame people with diabetes for using insulin or individuals with high blood pressure for taking medication. In fact, people likely aren’t saying, “Wow, have you brought down your A1C?” There’s a reason for this, and it separates obesity from other chronic conditions.
“Obesity is on display for everyone to see, unlike many other medical conditions,” says Ali.
A small
“This research is consistent with previous studies suggesting that there are differences in hormones that regulate hunger and fullness and in regions of the brain that impact responses to food in individuals with and without obesity,” says Hymowitz.
But Hymowitz urges people to exercise caution when interpreting the study.
“The results of the study do not indicate that it is obesity that caused changes in the brain, but rather that there are differences between individuals with obesity and individuals without obesity in how the brain responds to food,” she says.
“However, this research is important because it does provide additional evidence that the brain and gut play much more of a role than we previously thought in regulating appetite and fullness and that eating behaviors and weight is not simply a matter of how much we eat and our level of activity,” she adds.
Hymowitz also points out that it provides more support for prescribing medications like semaglutide for individuals living with overweight or obesity who qualify.
Being shamed for using drugs like Ozempic can increase both short and long-term health risks.
“Shaming a person by making them seem weak for taking medications can deter some people from seeking help,” says Ali. “Obese people may see themselves as lacking in willpower or self-control because of the shaming.”
Shame could also cause someone to stop taking the medication after they’ve started, which often results in weight regain, increasing health risks associated with chronic obesity.
“Obesity is associated with increased mortality and disruption of quality of life in addition to having an association or effect on virtually every organ system in the body,” says Kane.
The
- All-cause mortality
- High blood pressure
- Type 2 diabetes
- Sleep apnea
- Body pain
- Cardiovascular disease
- Some cancers
If you find yourself being shamed (or are concerned you might be) for taking weight loss medications, experts suggest that keeping the following things in mind may help.
You don’t have to explain yourself
There’s no shame in taking medication, but you don’t owe anyone an explanation for how you lost weight.
“People do not need to tell anyone they are using medication…for help with weight loss,” says Ali.
If you tell people you’re taking a medication and want to offer a reason, it doesn’t need to be long.
“If they are confronted, they should explain they have a chronic medical condition similar to hypertension or diabetes and are seeking treatment,” says Dr. Ali.
Remove morality
The ideas that obesity is a symptom of “laziness” or “lack of willpower” and that medication is “weak” are laced with morality. Hymowitz encourages people to remove it — it doesn’t belong in this discussion.
“Understanding that obesity, and, in general, our body shape and weight is not due to lack of willpower or a moral failing, can help counteract shame related to using medical tools, whether medications or surgical options, to address obesity,” says Hymowitz.
Remember: Obesity is a condition like high blood pressure or high cholesterol.
“Although lifestyle changes can often help with these conditions, sometimes lifestyle changes aren’t enough to counteract strong genetic and other physiological contributions,” says Hymowitz.
Focus on the health benefits
Obesity is a highly visible condition with less-noticeable side effects, like an increased risk of cardiovascular disease and some cancers. Dr. Hymowitz suggests focusing on the latter, even if friends and family notice the former.
“It is also helpful for individuals to shift focus from the impact of such medications on weight and shape and toward the main reasons for using these medications, to improve overall health, and address medical comorbidities that are associated with obesity,” she says.
For Miller, he says he decided to use the times he was being shamed as teachable moments for others.
“Instead of getting angry, I began to try and educate them on the complexities of obesity and ways that it can be addressed properly,” says Miller.
Work with a doctor
There are plenty of misconceptions about weight loss medications — and obesity in general. Lean on your healthcare team for the most up-to-date information and support.
“A multidisciplinary team that includes behavioral health providers can provide tools to help navigate stigma and interpersonal stressors related to weight, and weight stigma,” says Hymowitz.
Miller says, “It also helped me to find support in other places, such as therapy and support groups, instead of relying solely on my friends and family.”
Reducing the shame around obesity and drugs like Ozemic may be a challenge, but it’s one that individuals can contribute to by not shaming individuals taking these drugs.
“It is also important for individuals doing the shaming to understand that obesity is a disease and not simply a matter of eating too much and not exercising enough,” says Hymowitz. “These medications are a medical tool, like many other medical tools we use to help with other health difficulties, and taking medications is certainly not the easy way out.”
That’s what Miller wants people to know, too.
“There is a lot of stigma and misunderstanding around obesity, and many people do not understand the complexities behind it,” Miller says. “I would also encourage people to understand that there is no one-size-fits-all approach to addressing obesity and urge them to be more open-minded when discussing the issue.”